Development, validation and evaluation of a professional resilience training module for medical interns

Medical internship is a period of structured supervised practical training after the completion of medical school. Interns face long hours, exponential knowledge growth, and at the same time saving lives of patients. This overwhelming responsibility sets the stage for them to develop mental healt...

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Main Author:	Roslan, Nurhanis Syazni
Format:	Thesis
Language:	English
Published:	2021
Subjects:	R Medicine
Online Access:	http://eprints.usm.my/50472/1/NURHANIS%20SYAZNI%20BINTI%20ROSLAN-FINAL%20THESIS%20P-UD000818%28R%29-24%20pages.pdf
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spelling	my-usm-ep.504722021-11-01T14:40:24Z Development, validation and evaluation of a professional resilience training module for medical interns 2021-07 Roslan, Nurhanis Syazni R Medicine Medical internship is a period of structured supervised practical training after the completion of medical school. Interns face long hours, exponential knowledge growth, and at the same time saving lives of patients. This overwhelming responsibility sets the stage for them to develop mental health problems. In the alarming scenario of mental health problems, research have highlighted the role of resilience in helping individuals to thrive in adversities. This study aims to develop an evidence-based and effective training module to promote professional resilience among interns. In the development phase, the researcher adopted the mixed method triangulation study design. The researcher conducted a multi-centre cross-sectional study to examine the prevalence and predictors of burnout, depression, anxiety and stress among medical interns. The researcher then conducted an in depth interview (IDI) study to explore the enablers and barriers to resilience development in the internship training. The Professional Resilience Skills Training (Pro-ReST) module was then designed guided by the findings from the mixed method study and educational model. The researcher conducted content validation with experts related to internship training and face validation with graduated medical students. Based on the refined module, the researcher conducted a parallel single-blinded placebo controlled randomized controlled trial (RCT) and diary study (embedded mixed method study) with interns from two training hospitals over a period of 10 weeks. In Phase 1, the findings revealed a high prevalence of interns with depression, anxiety, stress and burnout symptoms. Low level of resilience and maladaptive coping strategies consistently predicted burnout, depression, anxiety and stress in the internship training. The IDI findings revealed that resilience development during internship is not only driven by tenacity, but also hardiness, growth, reflective skills and control. The Pro-ReST module that was developed based on the DEAL model (Detection, and Evaluation of stressor, Action and Learning), focused on coping skills, and had an excellent Content and Face Validity Index. In Phase 3, the RCT revealed a significantly higher resilience level, planning and lower anxiety, stress symptoms, humour, self-distraction, denial, restrain, and venting in the intervention arm as compared to the control arm. However, the module also increased self-blame coping in the intervention group. The diary study revealed that many participants were more aware of their stressors and able to evaluate their coping strategies. This study found that the Pro-ReST module is effective in enhancing resilience among interns. However, interns resilience is not the total solution to mental health problems, and best works alongside systemic intervention at the organizational level. 2021-07 Thesis http://eprints.usm.my/50472/ http://eprints.usm.my/50472/1/NURHANIS%20SYAZNI%20BINTI%20ROSLAN-FINAL%20THESIS%20P-UD000818%28R%29-24%20pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Pergigian
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	R Medicine
spellingShingle	R Medicine Roslan, Nurhanis Syazni Development, validation and evaluation of a professional resilience training module for medical interns
description	Medical internship is a period of structured supervised practical training after the completion of medical school. Interns face long hours, exponential knowledge growth, and at the same time saving lives of patients. This overwhelming responsibility sets the stage for them to develop mental health problems. In the alarming scenario of mental health problems, research have highlighted the role of resilience in helping individuals to thrive in adversities. This study aims to develop an evidence-based and effective training module to promote professional resilience among interns. In the development phase, the researcher adopted the mixed method triangulation study design. The researcher conducted a multi-centre cross-sectional study to examine the prevalence and predictors of burnout, depression, anxiety and stress among medical interns. The researcher then conducted an in depth interview (IDI) study to explore the enablers and barriers to resilience development in the internship training. The Professional Resilience Skills Training (Pro-ReST) module was then designed guided by the findings from the mixed method study and educational model. The researcher conducted content validation with experts related to internship training and face validation with graduated medical students. Based on the refined module, the researcher conducted a parallel single-blinded placebo controlled randomized controlled trial (RCT) and diary study (embedded mixed method study) with interns from two training hospitals over a period of 10 weeks. In Phase 1, the findings revealed a high prevalence of interns with depression, anxiety, stress and burnout symptoms. Low level of resilience and maladaptive coping strategies consistently predicted burnout, depression, anxiety and stress in the internship training. The IDI findings revealed that resilience development during internship is not only driven by tenacity, but also hardiness, growth, reflective skills and control. The Pro-ReST module that was developed based on the DEAL model (Detection, and Evaluation of stressor, Action and Learning), focused on coping skills, and had an excellent Content and Face Validity Index. In Phase 3, the RCT revealed a significantly higher resilience level, planning and lower anxiety, stress symptoms, humour, self-distraction, denial, restrain, and venting in the intervention arm as compared to the control arm. However, the module also increased self-blame coping in the intervention group. The diary study revealed that many participants were more aware of their stressors and able to evaluate their coping strategies. This study found that the Pro-ReST module is effective in enhancing resilience among interns. However, interns resilience is not the total solution to mental health problems, and best works alongside systemic intervention at the organizational level.
format	Thesis
qualification_level	Master's degree
author	Roslan, Nurhanis Syazni
author_facet	Roslan, Nurhanis Syazni
author_sort	Roslan, Nurhanis Syazni
title	Development, validation and evaluation of a professional resilience training module for medical interns
title_short	Development, validation and evaluation of a professional resilience training module for medical interns
title_full	Development, validation and evaluation of a professional resilience training module for medical interns
title_fullStr	Development, validation and evaluation of a professional resilience training module for medical interns
title_full_unstemmed	Development, validation and evaluation of a professional resilience training module for medical interns
title_sort	development, validation and evaluation of a professional resilience training module for medical interns
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Pergigian
publishDate	2021
url	http://eprints.usm.my/50472/1/NURHANIS%20SYAZNI%20BINTI%20ROSLAN-FINAL%20THESIS%20P-UD000818%28R%29-24%20pages.pdf
_version_	1747822038845751296

Development, validation and evaluation of a professional resilience training module for medical interns

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